CAN SALINE REVERSE FILLER? Is saline an alternative to hyaluronidase? [Aesthetics Mastery Show]
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- Опубликовано: 23 авг 2024
- There's been a recent trend on social media of injectors demonstrating 'dissolving' hyaluronic acid filler using saline. But would this actually work under the skin, and should clinicians consider adding saline to their reversal toolkit?
In this week's Aesthetics Mastery Show, Dr Tim answers these questions by experimenting with some blue spaghetti and a handheld blender!
He also tackles common queries about filler reversal, including: what actually is hyaluronidase; how do the the various brands - Hyalase, Amphadase, Hydase, Vitrase, Hylenex - differ; and does hyaluronidase also break down the natural tissue?
Let us know in the comments if this helped.
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Dr. Pearce giving a biology class! thank you both!!
It is important to note some related in vitro studies, such as those of Marazzi and colleagues, evaluated the role of hyaluronidase in skin and soft tissue vitality [53]. High concentrations of this enzyme have been reported to inhibit skin vitality. It has also been mentioned that concentration-dependent hyaluronidase toxicity is the cause of postoperative periorbital inflammation after cataract surgery after regional anesthesia.
Love your show as a formal medical aesthetician I enjoy the scientific details
Really interesting, and perfect visual explanation. Thank you
Thanks For this video. Your a great team and so knowledgeable
Super grateful for Dr. and Mrs. Pearce.
Hello, Dr Tim your videos are so informative
Could you discuss pain control methods including devices, techniques, anesthesia and nerve blocks?
Given the rate of hyalauronadaise replenishment decreases with age, it would seem to me that hyalauronadaise being used to dissolve filler on a 30 year old would have a much better outcome than someone having dermal fillers dissolved in their 50’s -especially if they are post-menopausal and are not on an Estrogen replacement, and even more so if that filler has been in their skin, mixing with their own tissues, for a long time. It seems like doctors need to better consider how these things matter.
I'm only 22 and it's been 2 weeks since I had my filler dissolved. It aged me. I experienced facial fat loss and sagging. I look different.
Excellent clear explanation that patients should be able to comprehend!
Miranda’s nail polish color 😍looove it 😁
Also another fantastic video 🙏 bravo 👏
Great video and illustration👍
Great video. I'd love your thoughts on Hylase(R) and bee sting allergy. The PI and drug company have NO evidence that this is a contraindication. Most research I can find is for yellow jacket wasps with alternate hyaluronidase. Not sure if this is a general consensus in the UK but it is here in Australia.
Great analogy, thank you, hope your floor recovered!
You mention natural HA will return within a week, but for many it does not. Courtney Cox is perhaps the most well-known example - for a very long time after she had her fillers hydrolyzed/dissolved, her face looked skeletal, inhuman. It was not until she took further measures that she began to look normalized again. Just because you yourself have not experienced it, does not mean that it cannot happen. I think it’s quite arrogant for doctors to dismiss real patient experiences as psychosomatic simply because their experience doesn’t fit into the paradigm of the doctor’s understanding. Doctors are not omniscient, and there are MANY aspects of the human body that are not understood by medical science. I have many times been dismissed by doctors, and have had to do my own research to discover ways to manage my issues on my own. Patient experience needs to be approached with respect and curiosity, not dismissed.
I never dismiss these experiences. I always ask patients who contact me on social media to send photographs- I use these products in people I care deeply about, and I always gather information before concluding every case.
So far I have never seen a case where the appearance in the before and after photo matched the degree of emotional distress- I am confident that anyone with body dysmorphia who has hyaluronidase is at high risk of concluding that they have a new issue. I do not treat dysmorphic people if I identify them, and so personally in 15 years I have never had one of my patients who I have injected make this complaint, and I have never seen a good quality before and after photo in similar lighting which shows anything I can make a medical conclusion with. However, I am still looking. please feel free to share your experience. I am open to the idea that there are a small subset of people who have real physical changes, I just haven't seen this yet. support@drtimpearce.com.
If I have a bias, it is in teaching complications, so it would not be a bad thing for me personally to discover there is a problem with hyaluronidase- I just haven't seen anything that persuades me of this. I have no reason to pretend there isn't. My primary line of work is NOT selling procedures or treatments, it's in teaching complications. I am NOT popular with the drug companies who make these products and I have NO affiliation with any pharmaceutical company.
First of all, you're NOT Courtney Cox nor are you her physician. You dont know anything about what has happen to Courtney's face, known allergies, etc. So stop speaking as if you have first hand knowledge about Courtney having a "bad" reaction to filler dissolver. Further more, Courtney Cox is t,ransg3nder and looks horrible due to TS universally aging badly, because of the hormones & botched feminization surgeries.
Although I am unhappy with the results after using hyaluronidase, I want to be objective about the doctor. You touch on a very important topic and explain everything in some detail. That's great. Maybe it will provide psychological support to some of the people. Would you like to research fillers? There are many of them, but I think among patients dissatisfied with hyaluronidase there is a chain that is associated more with a specific filler, and not with the solvent itself.
It is possible that fillers adversely affect the production of native hyaluronic acid, after its dissolution, the body of some of the patients simply cannot produce the prescribed amount of hyaluronic acid. For example, I had a Zishel filler and it gave me a reaction. Crap filler in my case. If you ever do a filler review, take note.
I agree. I don't follow their medical data as a lot of it is biased and the majority of it is funded by companies. In this case, companies who produce hyaluronidase.
I follow individual experiences and collect my own data this way.
I analyze it and look for patterns before I come to a hypothesis.
This is a far more accurate way, in my opinion.
It's the same as a certain jab. The medical data was biased and funded by the companies.
The "real people" experiences are what matter.
Pharma is a HUGE business.
Bravo Dr. If I lived in UK you would be my Dr. Thank you.
Hi, if using saline would you inject the same as if you were using hylase? Same amounts? Thanks!
I am so happy I found your channel thank you Dr ❤
so another question came to my mind and I hope it doesn't sounds too dumb. is it possible that hyaluronidase reacts with the chemicals in hair dye? ok hear me out: on dye with h202 is always the warning of an allergic reaction and to do not use it when you have black henna on your skin. people get reactions sometimes weeks/months after dissolving ha-fillers and I'm sure that many ppl who do fillers and stuff also dye their hair (ofc not all) I'm sorry if this sounds stupid, I'm just trying to figure out why some people end up sick.. Any thoughts / experiences? Thank you 💕
Thanks, perfect explanation. You are a beautiful couple!
Such an amazing explanation and representation of the process. It’s always such a pleasure to watch you two interacting and pouring your knowledge. I have one question, I’ve seen also this new trend of injectors diluting even soft filler with saline before injecting with the hope of decrease the risks of VO. What are your thoughts on the subject? Thank you
It's possible it could reduce the risk if it's thinner than blood if all other factors were the same, but I think that's unlikely.
One issue is that short change HA molecules which are known to be inflammatory cause trigger clotting cascade and a vascular occlusion that way.
The biggest flaw is that it's arguably riskier for SEVERE VO to use products which flow very easily as they can flow into smaller vessels and deeper into the vascular tree- so you are more likely with certain injecting styles to cause a deep injury with a thin filler.
Obviously longevity of the product and the aesthetic result will be affected.
I would suspect this is financially driven to a degree too... as you are making your most expensive commodity go a lot further (at least initially).
@@DrTimPearce How many units would you use to dissolve 1ml of rha4 25mg/ml & rha1 15mg/ml? I’ve had 0.5 in each nasolabial fold, as far as I understand the rha 4 was injected into the higher part of the fold, and the rha1 in the lower part. I am just not loving it & I’m only 4 days out. Is there also a time frame to wait before dissolving?
QUESTION - after the enzyme breaks down the filler into smaller components, what happens to those components? Can the components stay stuck in there, or they all removed by the body?
Your body reabsorbs them ( it’s more of a watery sugary solution by then) and processed by the body and peed out along with normal waste.
Does it make a difference what saline solution you use when reconstituted with the hyaluronidase? Saline bacteriostatic or saline non bacteriostatic make much of a difference when mixed to dissolve filler.
Which is better?
Hi
Do you believe that It can dissolve Ellansé ? I am struggling with this filler in my temple 🙏
I am allergic to hyularonidase so I asked my nurse to inject saline into the filler . It worked for me . I did massage it straight after though for about 10 minutes . I’m impressed 🙂
How soon after the initial filler did you get it dissolved with saline?
So, did you get rid of the filler?? Omg if that works I could finally get my botched filler removed without risking my face
@@WickedRxqueen Did you try injecting saline yet? It doesnt hurt to try and i would much rather "flatten" my filler out with sodium chloride than try hyaluronidase (even a very diluted version) and have my natural ha affected. I just ordered a 10ml of sodium chloride and once it arrives i will be inject about .10ml in my cheek area.
V P hi! Not yet, but it seems like a safer option. I hope everything turns out well for you🙏🏻. Please keep us posted! 🤞🏼 Good luck!
@@VP-kr2vd how did it go? Any updates?
I am highly allergic to wasp stings and I was fine using hylerandase.
Hi using hyaluronidase caused skin damage and skin aged faster
@@vocalofqueen5707 you asking a question or making a statement lol
Perfect🤗🤗 as usual😊
Excellent info
Really useful, thank you
Excellent video
Thank you Bella, glad you enjoyed it :-)
The in vitro demo showed a different outcome than your noodle demo 🧐
The hyaluronidase I used required saline to me mixed to activate so I don't understand this.
Hi Mary. Thanks for the question. The hyaluronidase comes in powdered form, so it needs to be mixed up with saline so that it's in a form that can be administered. However, it's the hyaluronidase drug itself that's mainly causing the reversal to take place, not the saline.
In my experience
I do patch test most my new clients with hyalronidase before filler
So each new client I will not inject if positive result
It helps and they feel we care about their welfare
Doctor, a question about dissolving hyaluronic fillers.
Hyaluronic acid is a polysaccharide, isn´t it? These sugars are broken down by the enzyme a-Amlyase, which is also found in our saliva. Instead of using hylauronidase, which breaks down tissue, couldn't we simply use amylase-enzymes to dissolve it? I mean, you can use bromelain to break down proteins and reduce inflammations... Just a thought. Thank you ♥
Amylase hydrolyses the alpha 1, 4 glycosidic bonds randomly in the starch, but hyaluronidase is bonded differently- the polymer is linked by β-1,4 and β-1,3 glycosidic bonds. Amylase therefore would not work- though I like your thinking. Enzymes are very specific- one of the reasons I don't believe hyaluronidase is likely to affect collagen.
@@DrTimPearce thank you for the great explanation, Doctor :) it's really more complex and complicat then I thought. Thanks for sharing some of your knowledge :)
10:55 love this 🙌🏼
What about diluting the hylase way more than the usual recommendation to avoid over dissolving, say if someone just wants a bit of lip filler migration above the lip slightly dissolved?
I believe you’d dilute it with more saline. Sucks he’s ignoring questions like these.
but what about v.occlusion?
What about the chemical binder or cross linking chemical in Juverderm product? One is called 1,4-butanediol diglycidyl ether (BDDE)? Where does that go in relation dissolver? How does it interact with this chemical?
What I am thinking is, isn't there anything to end the binding chemical so that the body can metabolise the hyaluronic acid
@@helengtz ya that would be great 😔
yeah degrading the binding agent rather than the bound material sounds like a better course of action
YOU ARE AMAZING.
I hope you did not flood the house :) What about using PRP when you have no hyaluronidase in the clinic? we have it in the blood so could be concentrated while you get the hyaluronidase vial on the way?
Does hyalunodise needs to be mixed with Saline? The hyalunodase I saw was liquid. Also after it was injected the lump of HA feel so much denser it did not work at all and feel it s actually bigger, what to do?
11 mo ago - Q. Did your bump ever go down with the saline?? It sounded like it was just a bit bigger from the extra volume.
Yes or NO ???
So once the allergies is already under the skin will it naturally go away?
PLEASE HELP ME
DOES SALINE DISSOLVE ELLANSE? ( policaprolactona)?
Heat helps dissolve Ellanse. Saline won’t do anything. I have used Radiofrequency and it really makes a difference. You can do it at home with Tripollar VX, It did work for me
@@julienFrenchDude can you please send me the picture of this machine in my Instagram DM on Instagram? And how much heat should I use ?
@@julienFrenchDude did you do it on your own? And how much heat?
Is it best to use for volii skin booster reversing
Why use saline to attempt to dissolve filler. You will more than likely increase the size of the filler rather than reduce it as most hyluronic acid expands with water, depending upon the filler of course.
Hi
Do you believe that this can dissolve ELLANSÉ ? I am struggling with this material on my temple 😣🙏
@Creative Renewal I discovered that just heat ( time and a lot of patience ) to be free from
Ellanse . This material is a toxic garbage
@@RenataLocutora I also need to get rid of the filler. But filler is sterilised with heat so I think it's heat resistant
@@helengtz Hi ! I found a way to reverse ! Heat is the key !
@@RenataLocutora that's good news! please help me. Heat in which way, what did you use?
But what if you’re allergic to hyalase?
I’m allergic to the dissolver is there anything I can do
which brand(s) of dissolver are you allergic to? have you tried hyalase?
Would HA diluted with saline be safer to inject? I don't mean for areas that require structure, but for plumping up lines/wrinkles. It seems like it would be less likely to cause occlusion.
I don’t think fillers would work how they are designed to if mixed with saline. Watch what happens when filler is mixed with saline on a mirror outside of the skin
Meso therapy products do this without the same risk as fillers .
@@ebeb516 But don't meso products usually get absorbed by the body quickly?
@@ebeb516 meso doesn’t work
@@GunterforeverHi. Can you elaborate? I’m interested in your statement. TIA
Thank u
I used triamsilon and result id satisfaction
Who knows an online distributor selling Hylenex brand? I am allergic to the bovine-derived Liporase : (
I used Syniro a few days ago dyi and think I injected in a vein on the corner of my mouth. It's been 24 hours and it is looking a bit better. The company says this product can cause an occusion but it should start to dissapate in a few days. Any thoughts?? Should I feel worried, I have no hyaluronidase on hand.
I hope you were able to see an asthetic doctor who is educated in filler and had education like Dr. Pierce who was able to assist you. Please share if you did have an occlusion or if it was just a bruise and share how your face has healed and what process was used to assist your recovery. Thank you for sharing.
I recently had a positive aspiration in the corner of my mouth (lower lip)..i am diy too.....dear, buy it Liporase Hyaluronidase + Saline ,ok...and you have peace of mind if something goes wrong...how did your filling in the vein turn out in the end?
I personally know people who have tried this and believe it has worked for them because their filler lumps have gone and they say they feel as if most of the filler has been dissolved this way.
Upon further questioning they explained that the saline was injected and then VIGOROUS massage was used for a period of time.
My off the wall mental theory is that perhaps the saline Increases the effectiveness of the vigorous massage (in breaking the filler down) by lubrication and by helping to flush the broken parts away.
I can definitely invisage it facilitating some dispersal with the massage
maybe this also works for the same reason it is easier to mix powder into water when the water bottle is only 1/3rd full: the air provides space to create more turbulence by shaking the water against the sides of the bottle. When the bottle is completely full of water, it is not possible to get such vigorous turbulence by shaking, the water merely swirls. So in vivo, perhaps the saline opens extra space in the tissue cavity (acting like air in the water bottle.) When you vigorously massage, the gel is able to squish around more actively in that extra space the saline creates. And the extra squishing heightens the 'vigor' of the vigorous massage. (🤷)
@@adrianparker6996 love this idea, and great analogy!
@@adrianparker6996 hmmm...interesting idea
Can hylase dissolve the filler in muscle too ?
Yes
Kind regards Mary. Clinical advisor for Dr Tim
People that even thought saline would dissolve filler or don't understand this should not be injecting. Good on you for making an effort to educate them but there is a reason most countries in the world except for yours have regulation in this industry.
I am allergic to hyalase. So you think using saline isn't safe or what do you mean?
Ok so no hope for me 😭😭😭Just got saline injected into my radiesse. Still swollen but was hoping it would get rid of it😔
might help it disperse a little, so it may be less visible.
Did it work finally? Can you keep us updated?
@@helloyou5277 no it didn’t work. Nothing has worked never get radiesse it will ruin your life
updates?
Isn’t saline to remove tattoo’s?
the fact that dissolving with hyaluronidase is very bad for our subcutaneous tissue, based on a number of negative experiences, is clear as sun..... it rather strikes me wierd, that for such a dangerous problem as blockage of a vessel is, are enough massage, heating and aspirin are enough /if the patient is allergic to hyalurase/
Experience is not a great guide. We need objective data, which is completely missing.
Can saline eye drops help dissolve old eye filler?
Unfortunately not Mara. Time will help as your body metabolises it or an enzyme called Hylauronidase with break it down.
Kind regards Mary. Clinical advisor for Dr Tim
@@DrTimPearce thank you
Interesting, however if hyaluronic acid is constantly replenished by the body, then why is dermal filler necessary in the first place? TY
It is replenished but in diminishing amounts as we age. At about 30 years of age, we do not make HA as fast as we use it and over time the classic signs of aging begin to appear
Filler is used for volume loss. Ur own HA can’t give you cheeks or a jawline
I think it is complemented to the extent that it is genetically given to you... but you want par excelance/ lips bigger than your nature...
@@ryflint6104 not only for loss of volume,..but also to change the shape of certain parts of the body, natural volume, etc
It doesn’t return in a week!!
maybe never
🔝
Hylase ruined my face. It should be used in emergencies
How have you been? Are the results getting back to how they used to be before the hylase? I know it must have been a stressful time period for you. I'm going to inject saline to see if it helps disburse my overfilled cheeks. They look awful.
@@VP-kr2vd it permanently changed my face in a way it never was before. Now I have a dent in my face. I didn’t know what that meant before. Yes it got rid of volume but unnatural . It was a huge lesson for me . I really depended on filler and Botox and would never stop but I think it’s breaking me of that. It still is stressful for me. I go to therapy about it . less is more. I wish I could go back and tell myself not to mess with it ever again but I would have never listened. The dissolver aged me. It is used in mesotherapy. Some drs told me as a dispersant . U won’t look how u did pre filler. It gave me saggy skin in the spot and changed my skin there. You want to protect your skin as you age. I even get facials, take vitamins and drink water. I’m sorry you have to experience that but probably best advice is leave it alone or understand that if u will be at a new normal
Lady, you are saying everything ruined your face lmao trollin, you said hyaluronidase ruined your face on someones other post lol
@@Gunterforever because it did and I was sharing on posts about it because it did impact my face in a negative way
@@Gunterforever hylase is same as Hyaluronidase